Antiphospholipid syndrome is autoimmune acquired thrombophilia associated with the formation of antibodies to phospholipids, which is manifested by recurrent venous or arterial thrombosis and/or pathology of pregnancy. Antiphospholipid antibodies are a heterogeneous group of autoantibodies interacting with phospholipids, which are components of cell membranes and phospholipid-binding proteins of blood plasma. Antiphospholipid syndrome can affect vessels of any caliber and localization, with thrombosis accompanied by no morphological signs of inflammation in the wall of the vessel. Obstetrical pathology is manifested by loss of the fetus, which can occur at any time of pregnancy, as well as other complications of pregnancy, such as preeclampsia and placental insufficiency. Based on the classification criteria, antiphospholipid syndrome is diagnosed if one of the clinical criteria (thrombosis or pregnancy complication) and one of the laboratory criteria including the lupus anticoagulant, antibodies to cardiolipin or β2-glycoprotein I, are revealed. The main tactic of the treatment of patients with antiphospholipid syndrome is to prevent thrombosis. For this purpose, the traditional therapy with anticoagulants and antiaggregants is applied. In addition, new medicines are being developed and evaluated

The article presents literary data on studying of the interrelation of bio-elements in environmental objects and human body. The results of the study testify to the fact that diet and drinking water are the main sources of intake of trace elements into human body and that the features of formation of the microelement status of the population directly depend on their mineral structure.

The article presents the data of the retrospective analysis of the causes of miscarriage in women with cervical correction performed by conservative, surgical or combined methods. The data of the multivariate analysis made it possible to identify the significant risk factors for miscarriage (threatening interruption of pregnancy in the second trimester (β = 0.21, p <0.001), presence of spontaneous late abortion after 16 week and spontaneous preterm birth (β = 0.11, p = 0.038) in the history, «short» cervix revealed by the method of transvaginal ultrasound cervicometry performed before the correction (β = 0.19, p = 0.04). The combination of all the three factors leads to miscarriage in 71.4%.

Objective: to increase the efficiency of the treatment of uterine endometriosis complicated by uterine bleeding, based on the differential application of hysteroresectoscopic endometrial ablation, a levonorgestrel-containing intrauterine system, and gonadotropin-releasing hormone agonists. Material and methods: The study included 93 patients with uterine endometriosis complicated by uterine bleedings who were treated using the levonorgestrel-containing intrauterine system (31 patients), hysteroresectoscopic endometrial ablation (29 patients), and the combination of these methods (33 patients). The control group consisted of 23 patients without genital pathology. The treatment outcomes for the subgroups were analyzed based on studying clinical, anthropometric, sonographic, laboratory, immune-enzyme, endoscopic, immunohistochemical, morphological, and morphometrical parameters. Results. The levonorgestrel-containing intrauterine system is efficient (in 87.1% cases) for the treatment of patients with adenomyosis in cases when the size of the uterus does not exceed 250000 mm³, and possesses the main local and minimal systemic effect. It is comparable to hysteroresectoscopic endometrial ablation, whose efficiency in the elimination of uterine bleedings is 82.76 %. If the size of the uterus ranges from 150000 to 250000 mm³, the combined treatment strategy should be preferred (hysteroresectoscopic endometrial ablation, and the levonorgestrel-containing intrauterine system), which had 100 % efficiency in the corresponding group, and gonadotropin-releasing hormone agonists should be used. In the long-term follow-up study (1-5.3 years), the efficiency of the treatment with the use of the levonorgestrel-containing intrauterine system was 80.65 %, in the combined treatment - 100 %, in hysteroresectoscopic endometrial ablation - 72.41 %. Conclusion. The individualized use of the levonorgestrel-containing intrauterine system, hysteroresectoscopic endometrial ablation, the combination of these two treatment options as well as the application gonadotropin-releasing hormone agonists in the treatment of adenomyosis complicated by menorrhagia and other proliferative diseases of the endometrium and myometrium showed their high efficiency and reasonability.

Objective: to characterize the phenotype of lymphocytes in lymphoid infiltrates in various forms of thyroid pathology. Material and methods . The operating material of 112 cases of thyroid diseases has been studied. The immunohistochemical examination using monoclonal antibodies to the antigens CD3, CD4, CD1α, CD23, CD25, CD8 and TGF-β has been conducted. Results. The quantitative assessment of lymphocyte subpopulations in lymphoid infiltrates in the tissue of the thyroid gland in thyrotoxic goiter, autoimmune thyroiditis, nodular euthyroid goiter, and thyroid cancer has been given.

Objective: to assess the potential of using the results of ultrasound imaging of the inguinal channel in order to select an optimal method of hernioplasty for elderly patients. Material and methods . The work is based on the results of examination of 37 elderly patients with inguinal hernias of II, IIIа, and IIIb type according to L. Nyhus. Ultrasound imaging and intraoperative assessment of the topographic and anatomical parameters of the inguinal channel were performed. The height of the inguinal interval, cumulative thickness of the inner oblique and transverse abdominal muscles forming the overhead wall of the inguinal channel, and also the diameter of deep inguinal ring were measured. All the patients were operated under spinal cord anaesthesia. Results. The linear sizes of basic topographic and anatomical parameters of the inguinal channel in the elderly patients with hernia, received by ultrasonic imaging during the stage of the preoperative preparation and the morphometric research during the operative intervention have no significant difference. The height of the inguinal interval depends on the type of inguinal hernia in the elderly patients. The cumulative thickness of the muscles of the overhead wall of the inguinal channel in the elderly patients does not exceed 5 mm, out of them in 70 % cases it is within the limits of 4 мм. In inguinal hernia of IIIа type, the diameter of the deep ring of the inguinal channel is substantially less than that of IIIb type (p<0.05) and that of II type. Conclusion. Ultrasound imaging of the inguinal channel allows to objectively assess its basic topographic and anatomical parameters in hernia, and its results can be used for planning of the method of hernioplasty in elderly patients.

Objective: to study the efficiency of the software «Volot» for semi-automatic measurement of X-ray parameters and kinematic analysis of the lumbar spine. Material and methods. The assessment of the lumbar spine kinematics was performed using X-ray patterns in horizontal and vertical positions for 55 patients. The parameters were measured and biomechanics was analyzed using the program «Volot». Results. The assessment of the radiometric indicators revealed a significant decrease in the height of the ventral area of the disc and the angle of the closure plates by L4-L5 (0.16 (-0.57; 1.98) (p=0.023) and 0.25 (-2.37; 3.48) (p=0.035, respectively) and by L5-S1 (0.98 (-0.27; 2.10) (p = 0.001) and 1.37 (-0.84; 3.84) (p=0.042). The violations of kinematics of the motor segments concerned were detected in 42 (76.4%) patients (p<0.001), and in 28 (66.7%) cases out of 42 (p = 0.003) at the adjacent levels. Conclusion. We found a decrease during the vertical adjustment of the height of the disc and wedge angle at the level concerned in osteochondrosis of III stage. The program «Volot» allows us to diagnose violations of kinematics in 76.4% of the cases.

Objective :to evaluate the efficiency of the means of radiation imaging in the diagnosis of genital prolapse. Material and methods . The work presents the data of the complex analysis of the results of examination of 83 female patients with different clinical degrees of genital prolapse by means of excretory and retrograde cystography, MRI, and CT. Results . The article presents the results of static and dynamic MRI of the pelvis, as well as CT of the pelvis in patients with genital prolapse, and gives the evaluation of the informative value of these methods in the diagnosis of this disease. Conclusion . MRI and CT of the pelvis play a leading role in the documentation diagnosis of genital prolapse and clarification of its degree.

The article presents data of international consensuses on the diagnosis and treatment of precancerous changes and conditions of the gastric mucosa and analyzes the experience of application of modern diagnostic techniques by the multidisciplinary team of specialists engaged in the prevention of gastric cancer. In conclusion, the article states the possibility of transition from the position of «evidence-based medicine» to personalized techniques of diagnosis and treatment in the matters of cancer prevention.

Object: to study the physical and chemical properties of the lipoprotein complexes of rats` blood in the long-term administration of statins and vitamin D. Material and methods. The experiment was performed on 4 experimental groups of rats for 90 days: 1 - intact; 2 - placebo; 3 - intragastric administration of atorvastatin; 4 - intragastric administration of atorvastatin with α-calcidol. The lipoprotein blood complexes were isolated by the method of differential ultracentrifugation. The microflow and microviscosity of the lipoprotein complexes were determined using pyrene. Results. The placebo group revealed an increase of the micropolarity of the total lipid pool of VLDL and a decrease of the microviscosity of the annulary pool of LDL and HDL. The administration of atorvastatin reduces the microviscosity of HDL. The combined application of atorvastatin and α-calcidol reduces the microviscosity of HDL. Conclusion. We have drawn a conclusion about the complex effect of stress, atorvastatin, and α-calcidol on the physical and chemical properties of the lipoprotein blood complexes and a conclusion about the positive effect of atorvastatin and α-calcidol on the microviscosity of HDL.

Objective : to assess the real radiation-absorbed dose of transuranium elements in underground and aboveground organs of herbaceous plants in the area of PSRER. Material and methods . The objects of the research were aboveground and underground organs of Iris pseudacorus L., Convallaria majalis L., Phragmites australis (Cav.) Trin. ex Steud. The selection of the samples was carried out in Polesie State Radioecological Reserve. The specific activity of²³⁸Pu,²³⁹Pu,²⁴⁰Pu, and²⁴¹Am in the aboveground and underground organs was determined by the method of radiochemical analysis, on the basis of which the equivalent dose rate was calculated. Results . The equivalent dose rates of the isotopes of transuranium elements incorporated in the plant tissues are: 6.04×10^-1 micro Sv/day^-1 (aboveground) and 4.74 micro Sv/day^-1 (underground) in Iris pseudacorus , 6.86×10^-1 micro Sv/day^-1 (aboveground) and 9.01 micro Sv/day^-1(underground) in Convallaria majalis , 3,93×10^-1 micro Sv/day^-1 (aboveground) and 3.14 micro Sv/day^-1 (underground) in Phragmites australis . These rates are 4-33 times as little as the equivalent dose of¹³⁷Cs in the soil. Conclusion . The largest dose rate of transuranium elements is the share of the underground organs of the studied plants, besides²⁴¹Am makes the main contribution among transuranium elements.

Objective: to develop a method for accelerating the fixation of biopsy material by adding dimexide to formalin. Material and methods. The method of adding food coloring E124 (ponso 4R) (1 mg/ml) to buffered formalin was used to study its penetration into biopsy material by leiomyomas delivered for an urgent histological study. In the test group, dimexide was added to the structure of the biopsy material as a dye penetration accelerator at a final concentration of 20%. The material was evaluated morphometrically in percents of the area of the stained areas. Results. The complete staining of all the samples of the experimental series with the addition of dimexide was observed after 12 hours of the fixation, and in the control sample only in three pieces out of six. In the remaining three samples, 75; 76 and 86% were painted. In two observations of breast cancer the expression of the fixation with the addition of 20% dimexide concentration to formalin after 12 hours corresponded to 24 hours of the fixation in the usual way. Conclusion. The addition of dimexide to buffered formalin at a final concentration of 20% made it possible to substantially accelerate the fixation without distorting the results of IGH examining the expression of markers included in the standard panel of IHC studies (Er, Pg, Ki-67, HER2).

Due to the wide application of atomic force microscopy (AFM) in medical and biological sciences, the finding of parameters qualitatively characterizing the distribution of the values of various cell surface properties at the nanoscale level is becoming topical. The aim of the study was to reveal the features of the behavior of the parameters of roughness (R_q) and fractal dimension (D_F) assessed for AFM images of the surface of glutaraldehyde-fixed breast carcinoma cells (MCF-7 cells) with changing of the image resolution, the scanning area size, and the regions of the cells. It has been proved that the value of D_F for AFM images is limited by the minimal achieved scanning step. The mutual analysis of R_q and D_F of AFM images has revealed some difference in the prospects of these parameters and the advantage of the application of the parameter D_F=f(t) (dependence of the fractal dimension on the scale coefficient along the axis Z) to characterize the fine structure of the spatial distribution of the local topographic parameters and parameters of mechanical properties on the cell surface. The application of the dependence of the parameter D_F =f(t) on AFM images, makes it possible to quantitatively characterize the different cell regions (the leading edge, central area over the nucleus, transitional (middle) area).

Purpose: toperform the comparative analysis of adherence of patients with arterial hypertension to the treatment after preventive consultation provided by local therapists and physicianassistants in outpatient conditions. Material and methods. The research was carried out on the basis of the branches of the Central CityPoliclinic of Gomel. 220 patients of the employable age (the average age was 47.1±3.4) suffering from arterial hypertension made the selection group.The selection groupwas divided into two groups. The first group consisted of 110 men and women with arterial hypertension who were given individual consultations by physician assistants. The second group included 100 patients who were given individual consultations by local therapists. Results. On the basis of the received results the indices of the efficiency of updating of a way of life (EUWL),efficiency of medicinal therapy (EMT) and efficiency of medical support (EMS) have been calculated. It has appeared that they are indicative of high efficiency of the preventive consultation, as the expected efficiency of medicinal therapy (1.5) and that of medical maintenance (1.3) inboth the groups are identical. The final index of the expected efficiency of treatment (IEET)did not show any difference in the first and second selection groups (1,4). Conclusion . The preventive consultationsprovided by health care workers in the outpatient conditions have the comparable efficiency. The results of the research aimed at the assessment of adherence of able-bodied patients with arterial hypertension to the treatment afterthe preventive consultations providedby both the therapists and physician assistants have shown that it promoted positive changes in their way of life concerning the importance of modification of way of life, medicinal therapy, and constant medical maintenance.

Objective: to study the practice of domiciliary consumption and awareness about antimicrobial drugs (AMDs) among different population groups. Material and methods .The study of the practice of drug consumption and awareness about AMDs was conducted using the method of questioning: 433 people (respondents with higher medical and non-medical education, medical and non-medical students, schoolchildren) were questioned. The differences in the groups were assessed using the criterion χ², χ² with Yeats' correction. To assess the revealed dependence between the features, we also used the Spearman rank correlation coefficient (R_s). Results. We noted a widespread use of AMDs by the population. 85.3% of the respondents acknowledged the presence of AMDs in their home medicine chests at the moment of the questioning, most often they were semisynthetic aminopenicillins. From 17.0% respondents in the group of schoolchildren up to 47.6% respondents of the group of medical specialists (of medical prevention and medical prevention profiles) noted facts of taking AMDs without doctor’s prescription. Most often the respondents take AMDs when their body temperature increases above 38°C (from 23.8 to 56.7% respondents), and in acute respiratory infections (from 2.4 to 31.6% respondents). In general, students use AMDs more often than specialists with higher education, and the schoolchildren’s answers are similar to the answers of the specialists (i.e. potential parents). Medical students are a group of people with the highest awareness and demonstrate a responsible attitude to the AMD consumption. On the contrary, non-medical students demonstrate a behavior predisposing to the development of antimicrobial resistance (AMR) and the lowest awareness about AMDs. The respondents without medical education bringing upchildren under 18 showed statistically significantly more rational practice of the AMD consumption than the respondents without children. Conclusions. In general, trends of domiciliary AMD consumption and the level of awareness about AMR of the population of the Republic of Belarus are consistent with the results of large-scale WHO studies. The revealed different levels of awareness about the rational practice of domiciliary AMD consumption actualize the necessity for wide informational and educational work aimed at the prevention of AMR development.

During the sanitary and microbiological studies of water samples from open water objects located in the city of Gomel and Gomel region it has been found that the number of water samples containing E. coli is growing each subsequent year, which points to the poor sanitary state of these objects. A high correlation between the pairs «air temperature» and «proportion of positive samples» has been revealed.The obtained data indicate that the higher the daily (night) temperature is, the higher the content of microbiota is in water bodies.Positive trends of increasing amount of the organic matter in the water samples from the water bodies were revealed over the period of the research.

The article considers the effect of destructive groups on the psychic of teenagers through social networks and presents a clinical case of a female patient who came under the influence of such a group.

Polyarteritis nodosa refers to the group of systemic vasculitides affecting small and medium arteries. It is characterized by inflammation of the vascular wall with the development of aneurysmus and thrombosis. The article presents a rare clinical case of polyarteritis nodosa, which has not been diagnosed for a long time and gives the description of the diagnostic search, performance of differential diagnosis as a result of which the diagnosis of systemic vasculitis has been defined.

Multiple primary malignant tumors are one of the complex and insufficiently studied problems of clinical oncology. Over the past decade, an annual increase in the number of patients with polyneoplasia has been observed worldwide, which is associated with an increase in the overall oncological morbidity, improved diagnosis, good results in the treatment of oncological pathology and an increase in the life expectancy of patients. In the literature resources there are few data on the combination of uveal melanoma with other malignant tumors. Uveal melanoma is a rare type of melanoma, but among intraocular tumors it takes the leading place in terms of its incidence rate. Despite the successful local treatment, the prognosis for the patients remains unfavourable due to the high metastatic tumor potential. The article describes a clinical case of multiple primary malignant tumors one of which was uveal melanoma, which determined the prognosis of the patient.

Objective: to determine the clinical value of the change of nitrite/nitrate ions (NO_x) concentration in the blood serum on the first or second day in patients with passing infringements of brain blood circulation (PIBBC) and the probability of recurrent stroke during the year after PIBBC according to the NO_x measurement. Methods. We examined 58 patients with a transient ischemic attack, 35 patients with cerebral hypertonic crisis and 16 volunteers. We compared the NOx level in the blood serum, the activity of superoxidedismutase (SOD) and performed phenotyping of the peripheral blood leukocytes in the patients on day 1 or 2 and day 10 or 12 after PIBBC and once in the volunteer group. The occurrence of recurrent ischemic events was identified by means of a telephone interview for a period of 3 months and 1 year. Results. According to the NO_x concentration in the blood serum on first or second day, all the patients with PIBBC were divided into two groups: the first one with the NO_x subthreshold level (<33 Mkm) being stable after the course of basic therapy; the second one - with the NO_x above-threshold concentration (> 33 Mkm) decreasing during the treatment. The activity of SOD in both the groups was twice as little as that in the control group (p<0.001) and was not corrected in the first decade. Immunophenotyping of the peripheral blood leukocytes revealed signs of an evident inflammatory response with a decrease in naive fractions in both the groups and a greater degree of acute inflammation in the second group. There was no connection between the NO_x concentration on the first or second day from the onset and the prognosis of repeated ischemic events in the patients with PIBBC. Conclusion. The distribution of the PIBBC groups according to the NO_x concentration determined immediately after the onset of transient cerebral ischemia made it possible to reveal the heterogeneity of the studied cohort by the nature of the inflammatory changes which do not influence the prognosis of repeated ischemia.

The application of atomic force microscopy (AFM) for the study of micro- and nanoscale areas of the cell surface allows researchers to introduce new cell parameters and to obtain qualitatively new notions about the causes and mechanisms of changes of the cell properties. The aim of the work was to assess the prospects of AFM of cells using the example of blood cells for the study and development of new methods of disease diagnosis based on the specificity of AFM modes of operation and the recent AFM data on the cell surface properties.

Objective: to carry out the comparative assessment of the intensity and duration of the antibacterial effect of monofilament polypropylene and polyfilament threads made of polyglycolic acid modified with antibiotic-containing coating. Material and methods. The antibacterial activity of thread samples containing an antibacterial preparation from the group of fluoroquinolones against E. coli and P. aeruginosa and its dynamics after soaking the threads in isotonic sodium chloride solution for 18 days with a daily change of the solution were studied.The comparative analysis of other antibacterial threads was carried out. Results. The new biologically active surgical suture material based on polypropylene and polyglycolic acid modified with fluoroquinolone-containing coating has a pronounced and prolonged antibacterial activity against E. coli, P. aeruginosa . Conclusion. The new biologically active surgical suture has proved to be more effective than some known antibacterial threads